HIV positive women and couples have broad reproductive health needs that are not always met within HIV services. The integration of family planning (FP) services into Tanzania's HIV Care and Treatment Clinics (CTC) will address the fertility desires of CTC clients and ultimately result in the reduction of unintended pregnancies and HIV incidence. One strategy for integrating FP and CTC services is to use a "facilitated referral" model. Facilitated referrals are enhanced referrals for additional services that have been used in other settings and which are the preferred intervention strategy the Government of Tanzania would like to pilot test. This study will evaluate the feasibility, effectiveness, and costs of implementing a "facilitated referrals" intervention by examining FP use among female clients attending HIV/AIDS Care and Treatment Centers. This study will measure whether there is a reduction in unmet need for contraception among female CTC clients after the facilitated referral integration intervention has been implemented.

Proportion of female CTC clients with unmet need for contraception [ Time Frame: Before intervention begins (baseline) and 3 months after full implementation of intervention ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

Proportion of female CTC clients screened on fertility intentions and unmet need for contraception [ Time Frame: Three months after full implementation of intervention ] [ Designated as safety issue: No ]

Proportion of female CTC clients provided counseling on contraception or safe pregnancy [ Time Frame: Three months after full implementation of intervention ] [ Designated as safety issue: No ]

Proportion of female CTC clients who received referral slip for FP services [ Time Frame: Three months after full implementation of intervention ] [ Designated as safety issue: No ]

Proportion of female CTC clients whose contraceptive use/fertility intentions are recorded on their patient record form [ Time Frame: Three months after full implementation of intervention ] [ Designated as safety issue: No ]

Proportion of female CTC clients who are accompanied to FP services [ Time Frame: Three months after full implementation of intervention ] [ Designated as safety issue: No ]

Proportion of female CTC clients who receive a FP method same-day or make an appointment for sterilization [ Time Frame: Three months after full implementation of intervention ] [ Designated as safety issue: No ]

Proportion of referrals to FP services that are tracked by the FP clinic [ Time Frame: Three months after full implementation of intervention ] [ Designated as safety issue: No ]

Incremental cost per clinic of adding facilitated referral process for FP to existing CTC services [ Time Frame: First month of implementation ] [ Designated as safety issue: No ]

Descriptive data on the experiences and perception of CTC and FP providers and supervisors on how the facilitated referral for FP was feasible and effective within CTC services [ Time Frame: Three months after full implementation of intervention ] [ Designated as safety issue: No ]

Care and Treatment supervisors who are the immediate in-charge supervisor for the CTC clinic. (CTC supervisor)

Family Planning providers who provide services to clients. (FP providers)

Family Planning supervisors who are the immediate in-charge supervisor for the FP clinic. (FP supervisor)

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Please refer to this study by its ClinicalTrials.gov identifier: NCT00941876